In neuropsychology’s received paradigm, the “normal science” of assessment and treatment planning appears to be approaching a paradigm shift: first, there are the general developments in other neurosciences that inform the practice of neuropsychological assessment. Second, there is the shift in the purpose of neuropsychological assessment from differential diagnosis of brain pathology to predictions about activities of everyday functioning and treatment planning. Third, there is growing need that neuropsychologists update their outdated technology for ecologically valid assessments. The impending paradigm shift may be well served to include the utility of virtual worlds for ecologically valid neuropsychological assessments. Actualization of the potential of virtual worlds for assessment will require the following: comparisons with well-validated neuropsychological measures, data storage, improved documentation of specific computer hardware and software used in experimental methods, and enhanced methods and result reporting by the researchers publishing studies on virtual worlds.
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Neuropsychological assessment represents an integration of a systematized neurological assessment of functional cortical and subcortical systems and a precise scaling of psychometric measurement. A typical neuropsychological assessment evaluates several aspects of psychological functioning. In addition to measures of intelligence (e.g., IQ) and achievement, the neuropsychological assessment is made up of a battery of tests to examines multiple areas of functioning that also have an impact on performance of activities of daily living. The following represents a set of cognitive functions that is likely to be assessed: learning/memory, intelligence, language, visuoperception, and executive-functioning. The historical development of neuropsychology has resulted in a “normal science” that is informed by developments in psychology, neuroscience, neurology, psychiatry, and computer science. Each of these “informing disciplines” has gone through changes that challenge theory and praxes of neuropsychological assessment. These changes are what Kuhn (1962/1996) describes as paradigm shifts, in which new assumptions (paradigms/theories) require the reconstruction of prior assumptions and the reevaluation of prior facts. For psychology, the paradigmatic shifts are found in the move from mentalism (i.e., study of consciousness with introspection) to behaviorism (Watson, 1912), and then cognition (Miller, 2003) as now understood through connectionist frameworks (Bechtel & Abrahamsen, 1990). Neurorehabilitation has undergone a paradigm shift as a result of influences from basic and clinical research (Nadeau, 2002). For psychiatry (e.g., neuropsychopharmacology) the “paradigm shift” has been found in an understanding of psychiatric disorders and molecular biology models that account for gene/environment/development interaction (Meyer, 1996). Likewise, neuroscience has seen a shift related to the understanding of communication between nerve cells in the brain—shift from predominant emphasis upon electrical impulses to an enhanced model of chemical transmission (Carlsson, 2001). For neurology (and a number of related branches of neuroscience) a shift is found in new ways to visualize the details of brain function (Raichle, 2009). Finally, we are seeing shifts in computer science in the areas of social computing (Wang, 2007), information systems (Merali and McKelvey, 2006), and even the video game industry (Zackariasson and Wilson, 2010).